Feature Archive

The Future of Breast Cancer Screening

An array of high-tech detection techniques and devices is on the scientific horizon.

By Dulce Zamora
WebMD Feature

Reviewed By Charlotte Grayson

Cora's doctor found a tiny growth in her right breast when she was 55 years old. To determine whether it was cancer, he inserted a small tube inside her nipple to extract cells for study under a microscope.

The results were inadequate, so he asked her to come in for another visit. This time, she was given anesthesia so he could surgically remove the suspicious tissue for examination.

Much to Cora's relief, the lump turned out to be benign, but recalling the whole process is enough to make the now 61-year-old tax auditor cringe.

"The nipple thing was very painful," she says, associating the unpleasant experience with other cancer-screening procedures she considers torturous, such as the mammogram, which involves placing one breast at a time on a cold device then flattened for filming.

Still, to this day, Cora, much like many of her peers, diligently subjects herself to such tests. Why?

Many shake it off as a small sacrifice for peace of mind. After all, women have a one in eight lifetime risk of developing breast cancer . The disease is the second leading cause of cancer death in females after lung cancer.

Yet medical visionaries are hoping women won't have to be martyrs for long. While mammography is still widely regarded as the gold standard for detecting malignancies, an array of new or improved technologies is now on the horizon -- using magnets, electricity, sound waves, and cellular biology as screening tools.

Some methods promise to make breast cancer screening more comfortable for women. A number pledge greater accuracy and fewer false positives. Still others are whispered to be borne out of entrepreneurial motivations. Doctors dream of someday being able to take a simple blood test to learn if a woman has breast cancer, or will develop it in the future. Some even hope tests will let them tell a woman when she will likely develop breast cancer, and what can be done about it.

But word on the scientific street is that such diagnostic wizardry will not be available anytime soon. What can you do in the near future? Here are newly improved or experimental screening techniques that may help you screen for breast cancer soon.

Improving Familiar Devices

The mammogram is the best tool for breast cancer screening at the moment. With about 85% accuracy, the X-ray device has spotted even malignancies that are too small to touch, ultimately saving many women from suffering and death.

But there's always room for improvement, and several groups are in hot pursuit of the next major screening method for breast cancer.

Next: The latest in imaging techniques.

Digitial Mammography
Digital mammography, which takes the X-ray image on computer rather than on film, is gradually becoming available. There are now about 300 such units in use around the country, according to the American Cancer Society.

The instrument "offers enormous potential" because the pictures can be manipulated, says Robert A. Smith, PhD, head of screening at the American Cancer Society.

Much like digital photographs currently taken by consumer digital cameras, breast images taken by digital mammography can be magnified, and the resolution can be adjusted to get a clearer picture.

While easier to use, digital mammography is not more successful at finding cancers than traditional mammograms -- and the cost of each machine tends to be prohibitive.

Computer-Aided Detection Devices (CAD)
Smith says the digital imaging technology could especially improve with better-programmed computer-aided detection (CAD) devices, which are now used by some labs to analyze standard mammograms and act as second-opinion readers for radiologists.

Early tests show CAD can help point out cancers otherwise missed by experts. Yet there is an ongoing debate about whether a machine can sufficiently replace a second radiologist in reviewing test results.

Ultrasound
Medical experts who want to evaluate problems first found during a mammogram or a physical exam often turn to ultrasound technology. An ultrasound device releases sound waves into the body, and creates a picture of the breast from the bouncing back of the waves. The idea is that sound echoes differently of off masses of various consistencies, such as fluid-filled cysts, solid tumors, or normal tissue.

Ultrasound has been around for decades, but improvements to the technology promise to make it more helpful in looking for cancer. One advance of note is still in the experimental stages: an ultrasound that takes 3-D images of the breast as opposed to 2-D ones.

MRI
Another breast detection technique that scientists have gradually enhanced over the years is magnetic resonance imaging (MRI). In this method, a large magnet, radio waves, and a computer work together to produce what experts consider a very clear, cross-sectional picture of the breast. Furthermore, experts can examine specific areas by injecting a dye in the veins, which collects in problematic tissues, making them more visible in the MRI picture.

Similar techniques are now under investigation, such as magnetic resonance elastography (MRE), which draws an image of the breast based on the elasticity of vibrating tissue.

Next: Experimental Techniques Ahead

Toward a Better Image (of Breasts)

Many methods to check for breast cancer are still experimental right now. Often, women at high risk of developing the disease turn to clinical trials of these imaging devices in an effort to ease their concerns.

Some of these experimental methods are:

  • Positron emission tomography (PET). This technology makes use of the notion that a tumor has a higher metabolism than normal tissue. When a radioactive substance is injected into a patient's vein, it travels to rapidly dividing cancerous cells, which have greater nutrient needs. Ideally, a PET scanner would detect the activity and produce an image of it.